心脏型脂肪酸结合蛋白对早期急性心肌梗死的诊断价值

目的：探讨心脏型脂肪酸结合蛋白在早期急性心肌梗死中的诊断价值。方法收集因“胸痛、胸闷3 h 以内”就诊，拟诊为急性心肌梗死患者186例，检测所有入选者的血浆肌酸磷酸激酶同工酶（CK-MB）、肌钙蛋白-I（CTn-I）和心脏型脂肪酸结合蛋白（H-FABP）。比较3种指标对早期急性心肌梗死诊断的敏感性和特异性。结果与非心肌梗死组和对照组相比，急性心肌梗死组患者血浆 CK-MB、CTn-I 及 H-FABP 明显升高（P ＜0．05）；与 CK-MB 和 CTn-I 相比，H-FABP 对3 h 以内的急性心肌梗死诊断的敏感性较高，而特异性则低于 CTn-I，但高于 CK-MB。结论对于发病3 h 内的急性心肌梗死患者，检测 H-FABP 可以在一定程度上提高对早期急性心肌梗死的诊断率。

Value of heart-type fatty acid-binding protein for early diagnosis of acute myocardial infarction

Objective To investigate the value of heart-type fatty acid-binding protein in the diagnosis of early myocardial infarc-tion.Methods In 186 cases of suspected acute myocardial infarction due to ＂chest pain,chest tightness＂ for 3 h,plasma CK-MB, troponin-I（CTn-I）and heart-type fatty acid-binding protein（H-FABP）were detected.The sensitivity and specificity in diagnosing early myocardial infarction were compared among 3 kinds of indexes.Results Compared with the non-infarction group and the con-trol group,plasma CK-MB,CTn-I and H-FABP in the acute myocardial infarction group were significantly increased （P 〈0.05 ）;compared with CK-MB and CTn-I,the sensitivity of H-FABP to the diagnosis of acute myocardial infarction within 3 h was higher, but its specificity was lower than that of CTn-I and higher than that of CK-MB.Conclusion For the patients with acute myocardial infarction within 3 h after onset,detecting H-FABP can increase the diagnostic rate of early myocardial infarction to a certain extent.